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Table 4 Description of missed injuries

From: The effect of tertiary surveys on missed injuries in trauma: a systematic review

Author, year, origin, N (N)with MI Area involved % (N)with clinically significant MI Description of change in management Mortality and morbidity
Enderson, 1990, Tennessee, USA N=399 36 MSK 51 7 OT, N= 7 Nil deaths
Spinal 12 (MSK N=3, Facial N=1, Abdomen N=3) Stroke, N=1
Facial 5
Thoracic 12
Abdominal 15
Vascular 5
Biffl, 2003, 81 vs. 52 MSK 32 vs. 46 Not reported Not reported Not reported
Rhode Island, USA Spinal 29 vs. 24
Pre TTS: N= 3412 vs. Post TTS: 3442 Abdominal 17 vs. 18
Brain 10 vs. 6
Pelvic 5 vs. 0
Vascular 3 vs. 2
Diaphragm 3 vs. 0
Vles, 2003, 49 Chest 33 22 OT, N=12 Morbidity unspecified, N=3
The Netherlands N=3879 MSK 27 (Chest N=1, MSK N=4, Facial N=5, Other N=2)
Skull 7 ICC, N=2
Facial 13 Cast, N=6
C-Spine 7
Other 10 Halo/brace, N=2
Hoff, 2004 42 Extremities 45 19 OT, N=4 (not specified) Not reported
Pennsylvania, USA Spine 21 Cast, N=7
N=432 Chest 15 Transfer, N=1
Pelvis/proximal skeleton 19 Change in advice, N=6, Home equipment, N=1
Soundappan, 2004 12 Head/face 33 1 OT, N=1 (not specified) Nil deaths
Sydney, Australia Spine 17 Prolonged LOS, N=4
N=76 Extremities 50 Delay in mobilisation, N=4
Howard, 2006, 13 Extremities 70 Not reported Not reported Not reported
Indianapolis, USA Face 12
N=90 Spine 12
Chest 6
Okello, 2007, 76 Head and neck 24 Not reported Not reported Not reported
Uganda Face 8 Mulivariate regression shows higher morbidity and longer LOS in patients with MI compared to patients without MI. This may not reflect causality.
N=403 Thorax 11
Abdomen/pelvis 20
Extremities 26
Janjua, 2008 134 MSK 40 30 OT, N=11 (Orthopedic n=3, Laparatomy N=7, Death 1.5% (N=2: C1 fracture; epidural hematoma)
Sydney, Australia STI 36 Thoracotomy N=1) Complications 8% (peritonitis N=4 after missed hollow viscus injury)
Abdomen 6 Laceration repair, N=2
N=206 Nerve injury 9 Embolisation, N=1
(Hemo-) Pneumothorax 5 Not specified, N=17
Ursic, 2009 35 vs 62 Not reported   Not reported Not reported Mortality
Sydney, Australia Pre 3.5% vs. post 2.5%
Pre TTS: N=981 vs. Post TTS= 1006
Huynh, 2010 80 Orthopedic 60 31 OT, N=7 (Orthopedic N=4, Facial N=2, Spinal N=1) Not reported
North Carolina, USA Facial/plastics/dental 21 Cast, N=24
N=5143 Neurosurgical 16
   Ophthalmology 3
  1. Description of missed injuries. Anatomical area, clinically significant missed injuries, change in management and mortality and morbidity.
  2. MI Missed Injury, OT operating Theatre, ISS Injury Severity Score, TS Tertiary Survey, USA United States of America, MSK musculoskeletal. Not all columns add up to 100% due to low proportions not being reported.
  3. TTS Tertiary Trauma Survey.